MENTORING VS. COACHING VS. PRECEPTING: WHAT’S THE DIFFERENCE?

Veronica Vernon, PharmD, BCPS, BCACP, NCMP

Assistant Professor of Pharmacy Practice

Butler University

September 12, 2018

DISCLOSURE

The speaker has no actual or potential conflicts of interest

OBJECTIVES

1. Compare and contrast the purpose and responsibilities associated with precepting, coaching, and mentoring.

2. Describe methods used to facilitate conversations as a preceptor, coach, and mentor.

3. Identify communication strategies that can be employed in challenging situations.

FAMOUS TEACHING RELATIONSHIPS

http://www.cruxcatalyst.com/wp-content/uploads/yoda-luke.jpghttp://wandervogeldiary.files.wordpress.com/2014/05/mr-miyagi-the-karate-kid-630-75.jpg?w=655

What do these mentors have in common?

PRECEPTING

What are attributes of a “good” preceptor?

A PRECEPTOR…

Sets Expectations

Provides Feedback

Displays Passion

Is Confident, yet Humble

Challenges the Learner

Seeks Learning Activities

Cuellar LM, Ginsburg DB. Preceptor's handbook for pharmacists.Beck DE, Boh LE, PS O'Sullivan. Am J Pharm Educ. 1995; 59: 236– 46.

FOUR FACETS OF PRECEPTING

•Set expectations

•Create structured &informal learning activities• Topic discussions

• Journal clubs

•Provide the learner autonomy

•Evaluate performance & deliver feedback

Cuellar LM, Ginsburg DB. Preceptor's handbook for pharmacists.Weitzel KW, etal. AJHP 2012:1588-1599.

THE LEARNING PYRAMID

Direct instruction

Facilitating

Modeling

Nimmo CM, et al. Staff development for pharmacy practice. Bethesda, MD: ASHP; 2000

Culminating Integration

Practical Application

Foundational Skills and Knowledge

Coaching

APPRENTICESHIP MODEL

I do itI do it

and you watch

You do it and

I watch

You do it

Maxwell JC. Mentoring 101.

THE ONE MINUTE PRECEPTORHave the student commit to an assessment/plan

Require evidence

Teach concepts that can be applied elsewhere

Provide positive feedback

Give constructive feedback

Furney SL, et al. J Gen Intern Med. 2001; 16: 620– 4.

COACHING

A COACH IS…

• “ Someone who helps another person reach higher effectiveness by creating a dialogue that leads to awareness and action.”

•An individual who helps another come to their own decision

•An observer, a guide

Emerson B, et al. A Manager’s Guide to Coaching: Simple and Effective Ways to Get the Best Out of Your EmployeesAtul G. The New Yorker. 2011 (October 3). Available at: http://www.newyorker.com/reporting/2011/10/03/111003fa_fact_gawande

COACHING

•Assists an individual in reaching goals faster

•Several types of coaching:• Peer

• Career

• Performance

• Life

• Health

Whitworth L, et al.. Co-Active Coaching, New Skills for Coaching People Toward Success in Work and LifeTofade T. Am J Pharm Edu 2010; 74(3): Article 51.

CO-ACTIVE COACHING MODEL

Develop a connection

Listen/communicate effectively

Keep the end goal in sight

Ask powerful questions

Build self-awareness and self-esteem

Recognize their whole life

Whitworth L, et al.. Co-Active Coaching, New Skills for Coaching People Toward Success in Work and LifeTofade T. Am J Pharm Edu 2010; 74(3): Article 51.

CO-ACTIVE COACHING MODEL

Acknowledge efforts

Identify limits

Hold the individual accountable

Debrief learning

Celebrate accomplishments

Whitworth L, et al.. Co-Active Coaching, New Skills for Coaching People Toward Success in Work and LifeTofade T. Am J Pharm Edu 2010; 74(3): Article 51.

MENTORING

A MENTOR IS…

• “A trusted counselor guiding the professional development of an individual”

• “Knowledgeable and competent professionals who are one or more steps ahead of a trainee”

Byyny RL. Pharos Alpha Omega Alpha Med Soc Winter 2012; 1-3Rose GL, et al.. Acad Med 2005; 80(4): 344-348

THE ORIGINS OF THE MENTOR

•The Odyssey

•Athena appeared as Mentor

to Telemachus

•Provided encouragement

http://paesmem.stanford.edu

Smilor R. Entrepreneurship. Available at: http://www.entrepreneurship.org/en/resource-center/what-makes-yoda-so-good-how-to-be-an-effective-mentor.aspx

What are desirable qualities in a mentor?

What actions should a mentor take to ensure a successful relationship with the mentee?

SUCCESSFUL ACTIONS OF A MENTOR

ListensProvides

constructive feedback

Supports and challenges the mentee

Develops a personal

relationship

Designates time for the

mentee

White SJ. Hosp Pharm 2011; 46(5):332-335.Smilor R. Entrepreneurship. Available at: http://www.entrepreneurship.org/en/resource-center/what-

makes-yoda-so-good-how-to-be-an-effective-mentor.aspx

PRINCIPLES OF MENTORING

Focus on the needs of the mentee

Demonstrate perseverance

Mentors must give of themselves

Align passion and work

Model character

Smith RE. ACCP Academy Leadership and Management Newsletter 2007; 1(1): 1-3

WHAT NOT TO DO

•Attempt to solve the mentee’s problems

•Violate confidentiality

•Force opinions on a mentee

•Share “war stories”

•Attempt to create a “clone”

Smilor R. Entrepreneurship. Available at: http://www.entrepreneurship.org/en/resource-center/what-makes-yoda-so-good-how-to-be-an-effective-mentor.aspx

COLLABORATION

Mentor Mentee

Zachy LJ. The Mentor’s Guide.

How do you ensure success in a mentoring relationship?

THE MENTORING EQUATION

Johnson W. The HBR Blog Network. Available at: http://blogs.hbr.org/johnson/2011/10/get-the-mentoring-equation-rig.html

CREATING A POSITIVE EXPERIENCE

•Set expectations • Frequency of meetings

• Responsibilities of mentor and mentee

•Evaluate, evaluate, evaluate

How do you incorporate direct instruction, modeling,

coaching, and facilitation into your precepting?

MENTORING, COACHING, PRECEPTING: SIMILARITIES AND DIFFERENCES

Mentoring

• Involves sharing of knowledge

• Longer time investment

• Facilitates decisions

• Focused on the mentee

Coaching

• Involves questioning and assessing

• Limited investment

• Reflective listening

• Focused on tasks

Precepting

• Involves teaching and evaluation

• Limited time investment

• Focused on the learner and tasks

Atul G. The New Yorker. 2011 (October 3). Available at: http://www.newyorker.com/reporting/2011/10/03/111003fa_fact_gawande

COMMUNICATION

COMMUNICATING AS A PRECEPTOR/MENTOR/COACH

•Regular contact is essential

•Set clear expectations early

•Ask open-ended questions

•Maintain open lines of communication

•Utilize active listening

•Be vigilant of body languageAPhA and NACDS. Available at: http://www.therapeuticresearch.com/ce/documents/custom/apha_nacds.pdf

University of Pittsburgh Institute for Clinical Research Education. Available at: http://www.icre.pitt.edu/mentoring/effective.html

THE IMPORTANCE OF FEEDBACK

•Vital to the learning experience

•Preceptors may not meet learner needs

•Meant to improve a targeted skill or behavior of the recipient

• It is not an evaluation

•Novices vs. experts respond differentlySonthisombat P. Am J Pharm Educ. 2007;72:1–6.

Finkelstein SR, et al. J Consum Res 39; 22-38.

PURPOSE OF FEEDBACK

Actual performance

Desired performance

Actual performance

Desired performance

Cantillon P, et al. BMJ 2008;337:a1961.

FEEDBACK TECHNIQUES

Feedback Sandwich

Pendleton Model

Reflective Feedback Conversation

Cantillon P, et al. BMJ 2008;337:a1961.

FEEDBACK TECHNIQUES

Feedback Sandwich

• Reinforcing statement• Corrective statement• Reinforcing statement

Cantillon P, et al. BMJ 2008;337:a1961.

FEEDBACK TECHNIQUES

Pendleton Model

• Learner states what was good• Teacher agrees and elaborates• Learner states areas for improvement• Teacher states areas for improvement

Cantillon P, et al. BMJ 2008;337:a1961.Pendleton D, et al. The consultation: an approach to learning and teaching. .

FEEDBACK TECHNIQUES

Reflective Feedback Conversation

• Teacher asks about concerns• Learner shares concerns and what could have been

improved• Teacher provides opinion and support• Teacher asks learner what may improve the

situation• Learner responds• Teacher elaborates on learner’s response

Cantillon P, et al. BMJ 2008;337:a1961.

EFFECTIVE FEEDBACK

Timely Scheduled Specific

Straightforward Collaborative

Beck DE, et al. Am J Pharm Educ. 1995;59:236–46.Koons K, et al. J Am Pharm Assoc 2012;52: e273-e276.

Ende J. Feedback in clinical medical education. JAMA 1983;250: 777-81.

PROVIDING EFFECTIVE FEEDBACK

1• Prepare learner prior to the activity

2• Provide descriptive, relevant, and objective

feedback frequently

3 • Avoid overloading the learner with feedback

4 • Follow-up on action plans

Beck DE, et al. Am J Pharm Educ. 1995;59:236–46.Koons K, et al. J Am Pharm Assoc 2012;52: e273-e276.

Ende J. Feedback in clinical medical education. JAMA 1983;250: 777-81.

PROVIDING POSITIVE VS. NEGATIVE FEEDBACK

Positive Negative

Weitzel KW, et al. Am J Health Syst Pharm 2012 69:1588-1599

COMMON PITFALLS TO AVOID

• Judgmental feedback

• Insufficient “wait time”

• Lecturing inappropriately

•Close-ended questions

•Challenging learner beyond abilities

• “Sugar-coating”

•Not focusing on the learner

Quilligan S.. Clin Teach 2007;4:100-105.Maynard, R. Preceptor CE: Giving effective feedback to students and residents. Pharmacist’s Letter PL CE Live 2012.

GROW MODEL

G •Goal

R •Reality

O •Options

W •Way Forward

Passmore J, ed. Excellence in Coaching: the Industry Guide.

PERSONAL DEVELOPMENT PLANS (PDPS)

• Plan and tracks progress against goals

• SMART goals

• Professional and personal goals

• Important to update and assess progress with goals at regular time intervals

UW Institute for Clinical and Translational Research. Available at: https://ictr.wisc.edu/mentoring/individual-development-plan/

PDP EXAMPLE

•Name:

•Short Term Goal(s) (completion in 1-2 years):

• Long Term Goal(s) (completion in 5+ years):Skills Assessment Activities to improve

Goal Date

Mentor signature and

date

STRUCTURAL TENSION CHART

Action Steps Date Completed

Fritz R. The Path of Least Resistance for Managers.

Current Reality

Goal/Future

QUESTIONS TO FACILITATE MEETINGS

1. What do you really want to do?

2. What do you do well that allows you to reach your goal?

3. What is preventing you from reaching your goals?

4. What will you do differently tomorrow?

5. How can I help?

Tjan AK. HBR Blog Network. Available at: http://blogs.hbr.org/tjan/2009/03/five-questions-every-mentor-mu.html

COMPONENTS OF SUCCESSFUL MEETINGS

•Scheduled time at intervals determined by the mentor or mentee

•Assist the mentee in developing SMART goals

LEARNER SCENARIOS

SCENARIO #1

•TR is a learner on his clinical rotation at your site

•He was 10-15 minutes late on the first week of his rotation

•He was on time during the second week

•TR is now late again on the 1st day of the third week of his rotation and is unprepared for his topic discussion today

SCENARIO #2

•DE and GL are two students on their clinical rotation together

•Throughout the first week, you notice that DE appears to take more initiative and is more prepared for the rotation than GL

What other challenging precepting situations have you

encountered?

SUMMARY

•The roles of preceptor, mentor, and coach often overlap

•Clear and open communication is key

•Feedback is essential to the development of a student/resident/mentee

•Various feedback methods exist

•Tailor the approach to the student/resident

RESOURCES

•Stoddard DA. The Heart of Mentoring. 1st ed. Colorado Springs, CO: NavPress; 2003.

•Zachy LJ. The Mentor’s Guide. 2nd ed. San Francisco, CA: Jossey-Bass; 2012.

•Maxwell JC. Mentoring 101. 1st ed. Nashville, TN: Thomas Nelson; 2008.

RESOURCES CONTINUED

•Adams M. Change Your Questions, Change Your Life: 10 Powerful Tools for Life and Work. 2nd ed. San Francisco, CA: Berrett-Koehler Publishers; 2009.

•Bradberry T, Greaves J. Emotional Intelligence 2.0. 1st ed. San Diego, CA: TalentSmart; 2009.

MENTORING VS. COACHING VS. PRECEPTING: WHAT’S THE DIFFERENCE?

Veronica Vernon, PharmD, BCPS, BCACP, NCMP

Assistant Professor of Pharmacy Practice

Butler University

September 12, 2018